Allied Mental Health Services, P.l.l.c. | |
11104 W. State St. Star ID 83669 | |
(208) 286-7967 | |
(208) 286-9047 |
Full Name | Allied Mental Health Services, P.l.l.c. |
---|---|
Speciality | Community/behavioral Health |
Location | 11104 W. State St., Star, Idaho |
Authorized Official Name and Position | Cory L. Thacker (PRESIDENT/OWNER) |
Authorized Official Contact | 2082867967 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Allied Mental Health Services, P.l.l.c. Po Box 545 Star ID 83669-0545 Ph: (208) 286-7967 | Allied Mental Health Services, P.l.l.c. 11104 W. State St. Star ID 83669 Ph: (208) 286-7967 |
NPI Number | 1104011337 |
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Provider Enumeration Date | 09/11/2007 |
Last Update Date | 09/11/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104011337 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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Allied Mental Health Services, P.l.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11104 W. State St., Star, ID 83669 Phone: 208-286-7967 Fax: 208-286-9047 |